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P15 Anti-carbamylated protein antibodies’ levels are negatively correlated with circulating effector T-cells in a cohort of patients with systemic lupus erythematosus
  1. Silvia Piantoni1,2,
  2. Ilaria Cavazzana1,
  3. Francesco Poiatti1,
  4. Stefania Masneri1,
  5. Roberta Ottaviani1,2,
  6. Micaela Fredi1,2 and
  7. Franco Franceschini1,2
  1. 1Rheumatology and Clinical Immunology Unit, ASST Spedali Civili Brescia, Brescia
  2. 2Dept. of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy


Background/Purpose Anti-carbamylated protein antibodies (anti-CarP) were detected in a large cohort of patients with Systemic Lupus Erythematosus (SLE) in correlation with erosive arthritis but not with disease activity indexes. In animal models, T-cells may be activated by carbamylated epitopes playing a role in the development of arthritis. The imbalance between circulating regulatory (Treg) and CD28- effector T-cells was described in active SLE patients, explaining its involvement in disease’s pathogenesis. Actually, no data are available about the possible correlation with these T-cell subpopulations and anti-CarP levels in SLE.

Methods Eight SLE patients with a median (10th-90th percentile) SLEDAI-2K=0 (0–4), anti-dsDNA levels=34.1 (15.6–427.4) UI/ml (nv<7), SDI=1 (0–1.3) were enrolled. Serum anti-CarP levels were evaluated using a home-made ELISA (nv<340 AU/ml) and peripheral blood T cell immunophenotyping was done using Flow Cytometry (Beckman Coulter). Treg were defined as CD4+CD127lowCD25high T-cells.

Results Enrolled patients showed levels of anti-CarP=189.38 (93.5–341.1) AU/ml, Treg=2.2 (% of CD4+), CD4+CD28-=7.7 (4.8–22.5) (% of CD4+) and CD8+CD28-=30.3 (17.2–35.6) (% of CD8+). Analyzing possible correlations among different T-cell subtypes and anti-CarP levels, a significant inverse correlation was found between these autoantibodies and CD4+CD28- T cells (r=-0.8, p<0.01; Spearman rank correlation). No correlations were found between autoantibodies and other T-cell subpopulations or disease activity/damage indexes.

Conclusions In a small cohort of patients with serologically active SLE, anti-CarP autoantibodies were found as negatively correlated to circulating CD4+CD28- T-cells, which were described in association with disease damage, independently of age, gender, disease duration and activity. This suggest a potential role of anti-CarP as marker of SLE with a minor extent of T-cell activation and, consequently, with a possible better prognosis.

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